• 제목/요약/키워드: Medication error

검색결과 64건 처리시간 0.026초

정신분열병 환자에서 인지기능 및 정신병적 증상의 상관관계 (Correlation between Cognitive Functions and Psychotic Symptoms in Schizophrenic Patients)

  • 김용구;이정애;이소연;이분희;한창수
    • 생물정신의학
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    • 제13권3호
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    • pp.191-201
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    • 2006
  • Objectives : The purpose of this study was to investigate whether the cognitive functions would be correlated with psychotic symptoms and whether antipsychotic treatments would affect the cognitive functions after 8 weeks. Methods : The thirty-five schizophrenic patients were conducted in this study. The psychopathology was measured using PANSS. The memory function, executive function, and sustained attention were measured using Memory Assessment Scale(MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone(COG) in Vienna Test System. After 8 weeks of antipsychotic treatment, we retested the cognitive tests. Results : 1) The cognitive tests after the 8 week's treatment showed significant improvements in memory and executive function in the schizophrenic patients. On the other side, sustained attention did not show improvement. 2) The change of PANSS were correlated with perseverative response, perseverative error and total correct in WCST at baseline. WCST scores at baseline were correlated with negative symptoms, but not positive ones. Conclusion : These study suggests that 1) the impaired sustained attention could be a vulnerability marker in schizophrenia, 2) memory & executive function deficit could be reversible after treatment, and 3) medication might have a benefit in improving the cognitive functions in schizophrenia. Furthermore, the data supports that the better premorbid executive function was, the more favorable was the treatment response in schizophrenic patients. Finally, this study indicates that executive function might be an index of treatment improvement.

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사향(麝香) 및 사향(麝香) 배합(配合) 한약제제(韓藥製劑)의 구강(口腔) 투여(投與)가 백서(白鼠)의 기억(記憶) 및 뇌기능(腦機能) 활성(活性)에 미치는 영향 (The Effects of Moschus and Herbal Combination with Moschus by Oral Administration at Memory and Activation of Brain Ability on Rats)

  • 정현주;이유경;채중원
    • 대한한방소아과학회지
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    • 제23권1호
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    • pp.95-113
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    • 2009
  • Objectives This study was investigated to find how the orally administrated Moschus, herbal combination with Moschus, and herbal combination improves the rats' memory and rats' liver. These medications are generally known asthe memory improvement. Methods This study used the Sprague Dawley rats. They were divided into two groups - SD rats and orally administrated Saline(Control group). 0.473 mg/kg Moschus(HM-A), 153.9 mg/kg herbal composition without Moschus(HM-B), and 165.95 mg/kg herbal composition with Moschus combined(HM-C) Control, saline were orally administered. Each group was trained in the eight-arm radial maze task at the conditions of before oral administrated, and also right after third, sixth, and eighth by oral administration. Lastly, these animals were killed and were tested for brain tissue and serum AST/ALT level to measure how the medications were effected to the liver function. Results The result of radial eight-arm maze task test, the HM-B and HM-C groups showed significant decrease in mistakes from the fourth day of testing. Whereas, the HM-A group showed increasing in the error rate. HM-A and HM-C group of rats had significantly increased amount of acetylcholinesterase in the CA1 region of hippocampus, compared to the control group. Whereas, HM-B and HM-C group had increased level of ChAT compared to the control group. On the other hand, each experimental group did not show any significant difference to the level of serum AST/ALT and the weight ratio of the liver to the body. Conclusions This study provided evidences that the orally administered memory improvement herbal medication, and Moschus were effective to improve memory.

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간호분야 실무지침의 수용개작 방법론에 따른 경장영양 실무지침의 개발 (Development of Nursing Practice Guidelines on Enteral Tube Feeding using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;조명숙;박명화;김경숙;김정연
    • 임상간호연구
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    • 제20권2호
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    • pp.147-161
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    • 2014
  • Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

응급의료센터 자동약품분배 캐비닛시스템 운영으로 인한 야간 약국업무개선 (Improvement of Night Pharmacy Service by Automated Dispensing Cabinet System Implementation in Emergency Medical Center)

  • 김경희;김선아;이정연
    • 한국임상약학회지
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    • 제28권1호
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    • pp.51-56
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    • 2018
  • Objective: An automated process for medication preparation and dispensing is essential to improve the quality of work. To reduce night pharmacy workload, a new automated dispensing cabinet system was implemented in a hospital emergency medical center. The purpose of this study is to verify that implementation of an automated dispensing cabinet system will influence the efficiency of night pharmacy work. Methods: To evaluate the new system implementation, a retrospective study and survey was performed in the Ewha Womans University medical center. We compared the dispensing and near-miss error rates between the automated dispensing cabinet system and a night pharmacy. The degree of satisfaction of night shift workers with the new system was surveyed. Results: This study showed significantly reduced dispensing rates of night medications (56.1% and 37.3%; p < 0.01) and near-miss night medications (0.27% and 0.17%; p<0.01). Thirty-two persons responded to the survey, and the satisfaction score for the new system was 4.0 (${\pm}0.8$). The scores were high in order of efficiency, management, and convenience. Time requirement was also reduced because of the simple step of only reviewing in the pharmacy with the new system. Conclusion: Due to system implementation, workload was reduced and time was saved for not only night shift workers but also patients receiving emergency discharge medicine. It was suggested that this will have a positive effect on pharmacist medical service and patient safety.

일개 종합병원 간호사의 간호업무 전산화 활용에 대한 연구 (A Survey on Nurses' Utilization of Computerization in Nursing Practice)

  • 박경숙;최인순;강현욱;김나영;김미진;김소희;손진하;윤인자;주애라;홍미나
    • 간호행정학회지
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    • 제9권3호
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    • pp.367-378
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    • 2003
  • Purpose: The research studied to survey the degree of utilization, satisfactions and problems of the computerization in nursing practice. Method: The subjects were 176 nurses who are working at university hospital in Seoul. The research was operated by 75 questionaries which were developed and modified from precedence study of Kim(1998), No(1996) and Pang(1996). The data was processed by SPSS for window 11.0 and the results analyzed with number, percentile, average, t-test and ANOVA. Results: As the way of using computer system in nursing, the most nurses used that to Dr's order check, treatment activity, laboratory, barcode sticker, medication in order that were connected with order system mutually to other parts. The average degree of contentment from the computerization in nursing practice was presented as 3.855 in the full mark 5. The facility of stock management got the highest points(4.98). The problem was marked 3.12 and the biggest problem is interruption of work from the computer system error(4.03). The contentment of computerization in nursing practice by duty year was reflected a significant difference(F=5,457 P=0.005) and was not related with computerization and computer education(F=0.028 P=0.867, F=2.178 P=0.142).

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백색광 간섭계를 이용한 안구 돌출 측정 장치 설계 및 제작 (Design and manufacture of eyeball protrusion measuring device using white light scanning interferometer)

  • 장중수;김영길
    • 한국정보통신학회논문지
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    • 제23권1호
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    • pp.63-69
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    • 2019
  • 안와 내에서 안구의 상대적 위치는 여러 병적인 상태를 짐작할 수 있는 하나의 기준이 될 수 있다. 특히 안와골절, 갑상선 안질환, 안와 종양 등의 진단과 이에 약물 및 수술적 치료의 결과를 판단하는데 유용하다. 현재 안구 돌출 값을 측정하기 위해 주로 사용되는 대표적 측정 기기인 Hertel과 Naugle 안구돌출계 등은 검사자가 다를 경우, 같은 검사자가 반복적으로 측정하더라도 검사할 때마다 안와의 고정부위가 달라지는 현상, 또한 동일한 안구돌출계라고 하더라도 제조 회사가 다르다면 안와의 고정부위 디자인이 달라 검사자에 의한 측정 오차 발생이 필연적이다. 본 논문에서는 백색광 간섭계를 이용한 안구 돌출 측정 장치를 설계 및 제작하고 실제 사람의 안구 돌출을 측정하여 수동식 측정 방법에 비해 정밀도 및 반복 정도가 크게 높아진 것을 확인하였다.

Netspag Lens를 이용한 Mono vision에서 시력개선 효과에 대한 P-VEP 연구 (The Effects of Visual acuity increase in mono vision by the P-VEP study using Netspeg lens)

  • 김덕훈;배한용;김선태
    • 한국안광학회지
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    • 제10권3호
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    • pp.241-246
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    • 2005
  • 본 연구는 굴절이상을 가진 피검자의 단안에서 Netspeg lens를 착용 후 시력 개선의 상태를 P-VEP의 파형 분석을 통해서 검증하고자 하였다. P-VEP는 3 channel의 Bausch Lomb system으로 기록하였다. 10명의 성인 피검자(남성 5인, 여성 5명; 평균 21세, 연령은 19세와 23세 사이)의 눈을 검사하였다. 피검자는 전신건강, 약물복용, 유전, 알레르기 그리고 안질환을 포함하는 문진 등을 조사하였다. 시력과 굴절검사는 Netspeg lens를 사용하여 피검자의 단안을 기록하였다. 피검자는 P-VEP 기록을 하는 동안 교정된 시력을 통해서 단안의 P-VEP 자극을 본다. 연구의 결과 Netspeg lens를 사용한 단안은 사용하지 않는 눈에 비해서 시력 결상이 선영하게 자각되었다. 한편 P-VEP 검사에서는 Netspeg lens를 사용한 눈이 높은 진폭 나타 내었다. 그러나 P-VEP의 장복시간은 오히려 늦게 나타났다. 그러나 P-VEP이 형태에서는 Netspeg lens를 사용한 눈이 안정된 파형을 유지하였다. 한편 오른 눈과 왼눈의 유의성은 거의 없었다. 따라서 본 연구에서는 Netspeg lens를 사용한 단안에서는 그렇지 않는 눈에 비해서 시력과 시기능이 기능이 우수함을 나타내었다.

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의료보험 진료비 심사 간소화에 대한 방법론적 연구 (A methodological study on simplifying claims review system in medical insurance)

  • 김석일;강형곤;김한중;채영문;손명세;이명근
    • Journal of Preventive Medicine and Public Health
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    • 제28권3호
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    • pp.640-650
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    • 1995
  • After the introduction of National Medical Insurance in 1989, the medical demand has rapidly increased. The impact of increased medical demand was followed by an increase in the number of claims in need of review. We studied a new, fair method for reducing the number of claims reviewed. We analysed 90,583 outpatient claims submitted between September and October; claims were made for services given August of 1994. We finally suggested a screening system for claims review using a statistical method of discriminant analysis of the medical costs. The results were as follows. 1. In the cut-off group, age, days of medication, number of hospital or clinic visits, and total charge were significantly high. The cut-off rates according to the hospital-type and existence of accompanied disease were significantly different 2. According to ICD, the cut-off rate was highest in peripheral enthesopathies and allied syndromes(20.76%), lowest in acute sinusitis(0.93%). The mean charges were significantly different according to ICD and existence of cut-off. 3. We build discriminant functions by ICD with such discriminant variables as patient age, sex, existence of accompanied disease, number of hospital or clinic visits, and 9 detailed hospital or clinic charges included in claim. 4. We applied the discriminant function for screening those claims that were expected to be cut-off. The sensitivities comprised from 40% to 70%, and specificities from 70% to 95% by ICD. Acute rhinitis had highest sensitivity(100.00%) and other local infections of skin and subcutaneous tissue had highest specificity(98.45%). The expected number of cut-off was 17,762(19.61%). The total sensitivity was 49.62%, the total specificity was 82.57% and the error rate was 19.66%. We lacked economic analysis such as cost-benefit analysis. But, if the new method of screening claims using discriminant analysis were applied, the number of claims in need of review will reduce considerably.

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반복측정자료를 가지는 적응적 집단축차검정에서의 신뢰구간 추정 (Confidence Bounds following Adaptive Group Sequential Tests with Repeated Measures in Clinical Trials)

  • 조숙정;이재원
    • 응용통계연구
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    • 제26권4호
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    • pp.581-594
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    • 2013
  • 집단축차설계법은 중간분석을 실시하여 임상시험용 의약품의 유효성 또는 무용성이 조기에 발견되면 임상시험을 조기에 종료할 수 있는 시험설계법이다. 적응적 설계법은 중간분석 결과를 이용하여 시험설계를 변경하거나, 확률적으로 독립인 두개의 임상시험 결과를 결합하는 등 다양한 적응법으로 임상시험의 설계를 수정할 수 있는 시험설계법이다. 집단축차설계법과 적응적 설계법에서 주요하게 고려할 점은, 시험 전체적으로 제1종 오류를 적절히 분배하고 통제하여 임상시험 전체의 일관성을 유지하도록 하는 것이다. 반복측정자료 또는 경시적자료의 통계적 모형이 고려되는 경우에는 통계적 추론이 더욱 복잡하고 어려워진다. Lee 등 (2002)에서는 반복측정치를 가지는 임상시험에서 집단축차설계에서 미리 정한 기준에 의하여 임상시험이 종료된 후, 독립증분과 단계적 순서관계를 고려한 신뢰구간 추정법을 제안한 바 있다. 본 연구는 Lee 등 (2002)를 적응적 설계로 확장하였다. 적응법을 실시한 전과 후의 임상시험을 확률적으로 독립인 관계로 정의하는 검정통계량을 유도하여 적응적 집단축차검정법이 가능하게 하였다. 또한, 임상시험이 종료된 후 단계적 순서관계를 고려한 신뢰구간 추정법을 제안하였으며, 모의실험을 통하여 그 안정성을 확인하였다.

천궁(川芎)의 구강투여(口腔投與) 및 약침시술(藥鍼施術)이 흰쥐 MCAO로 유발된 국소뇌허혈(局所腦虛血)에 대(對)한 콜린성 신경보호효과(神經保護效果) 연구(硏究) (Effects of Cnidium of ficinale(CO) extracts through administrated by means of oral and herbal acupuncture method at GB2l acupoint on focal ischemic brain injury induced by MCAO in rats)

  • 김경선;윤대환;홍석;나창수
    • Korean Journal of Acupuncture
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    • 제22권3호
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    • pp.137-156
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    • 2005
  • Objectives : Cnidium officinale(CO) has been used for medication for stroke in the Oriental Medicine. So this study was planned to investigate the effects of CO on the focal ischemia-induced by Middle Cerebral Artery Occlusion(MCAO) in rats Materials and methods : The focal ischemia was induced by MCAO. CO extracts through oral administration and herbal acupuncture at GB2l was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task. For the neuroprotective effect of CO, we investigated AchE, ChAT, and NGF-expression by immnohistochemical method. Results : The error rate in the eight-arm radial maze task was significantly decreased in normal group compared to control group on 1-6days, OA-CO1(CO oral administration, 0.8g/kg) group on 1-6days, OA-CO2(CO oral administration, 1.6g/kg) group on 1-3,5,6days, HA-CO1(CO herbal acupuncture, 0.016g/kg) group on 2,3,6days, HA-CO2(CO herbal acupuncture, 0.008g/kg) group on 1-3,5,6days. The rate of correct choice was significantly increased in OA-CO1, HA-CO2. The density of neurons in the hippocampal CA1 was the most increased in OA-CO1, HA-CO1, HA-CO2. The density of ChAT in the hippocampal CA1 was increased in OA-CO1, HA-CO2. The density of ChAT in the hippocampal CA1 was significantly increased in OA-CO1, HA-CO2. The density of NGE in the hippocampal CAI was significantly increased in OA-CO1, OA-CO2, HA-CO2. Conclusions : These results suggest that CO oral administration with 0.8g/kg and CO herbal acupuncture with 0.008g/kg might be used as a regulator of cell death of cholinergic system induced by stroke.

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